Principles of therapy of cognitive impairment in depressive disorders

November 16, 2020
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The aim was to develop and evaluate the effectiveness of a comprehensive program of therapy and rehabilitation (CРTR) for patients with cognitive impairment (CI) in depressive disorders (DD). The proposed CРTR for patients with CI in DD implemented in four stages: diagnostic, therapeutic, rehabilitation and prophylactic. The diagnostic stage included a clinical and psychopathological assessment of the patients’ CI, an analysis of anamnestic data, clinical symptoms, dynamics and prognosis of the disease, the relationship of clinical and socio-psychological factors. The therapeutic stage included a set of pharmacotherapy and psychotherapy measures aimed at correcting CI, stopping DD, normalizing the psycho-emotional state, social adaptation and readaptation of the patient. The rehabilitation stage included a set of pharmacotherapy and psychotherapy measures aimed at restoring cognitive functions, strengthening the effect of antidepressant therapy, and restoring the patient’s social functioning. The preventive stage designed to maintain a normal psycho-emotional state, effectively resist stress, and prevent the recurrence of depressive disorders. In approbation of the developed CPTR, 97 patients with CI in DD make up the main group, who passed the CPTR course according to the developed program. The control group consisted of 93 patients with CI in DD who underwent a course of therapy according to traditional schemes. The effectiveness of the proposed CPTR in patients with CI in DD were proved, which consists in a more pronounced reduction of clinical manifestations of DD, improvement of cognitive functions, reduction of maladaptive and increase in adaptive strategies for cognitive regulation of emotions, improvement of social functioning in the main spheres of life.

References:

  • Abdurakhmanova R.F., Izzatov H.N., Khadibaeva G.R. et al. (2015) Depression in neurological practice: use of antidepressants (http://www.vestnik-ipovszrt.tj/?p=2254).
  • Azimova Yu.E. (2017) Depression and cognitive impairment: experience with vortioxetine in neurological practice. Med. advice, 11: 36–39.
  • Gimoyan L.G., Silvanyan G.G. (2013) Cognitive impairment: relevance of the problem, risk factors, prevention and treatment options (https://cyberleninka.ru/article/n/narushenie-kognitivnyh-funktsiy-aktualnost-problemy-faktory-riska-vozmozhnosti-profilaktiki-i-lecheniya).
  • Dobryanskaya M. (2010) Modern aspects of the treatment of cognitive dysfunction. Neuronews, 7 (26): 46–52.
  • Ekusheva E.V. (2018) Cognitive impairment is a topical interdisciplinary problem. RMJ, 12(I): 32–37.
  • Zakharov V.V., Vakhnina N.V. (2015) Cognitive impairment in depression. Effect. Pharmacoter., 1: 18–26.
  • Ilnitskaya T. (2016) Cognitive impairments in patients with mental and neurological pathology (https://neuronews.com.ua/uploads/issues/2016/8(82)/nn16-8_14-16_ea8724143e5f7777b4bfad8994b5708a.pdf).
  • Maruta N.O., Panko T.V., Fedchenko V.Yu. et al. (2017) Diagnostic criteria for depressive disorders at stages of providing medical aid. Ukr. Visn. Psychoneurol., T. 25, 1 (90): 135.
  • Mishchenko T.S. (2017) Cognitive impairments in the practice of a family doctor (relevance of the problem, risk factors, pathogenesis, treatment and prevention options). Family Medicine, 1(69): 21–24.
  • Ushkalova E.A., Ushkalova A.V. (2014) Pharmacotherapy of cognitive impairments of various origins: current state and promising directions. RMJ, 22: 1613.
  • Burmester B., Leathem J., Merrick P. (2016) Subjective cognitive complaints and objective cognitive function in aging: a systematic review and meta-analysis of cross-sectional finding. Neuropsychology, 26(4): 376–393.
  • Crocker L.D., Heller W., Warren S.L. et al. (2013) Relationships among cognition, emotion, and motivation: implications for intervention and neuroplasticity in psychopathology. Front. Hum. Neurosci., 7: 261.
  • Disner S.G., Beevers C.G., Haigh E.A., Beck A.T. (2011) Neural mechanisms of the cognitive model of depression. Nat. Rev. Neurosci., 12(8): 467–477.
  • Fernández-Blázquez M.A., Avila-Villanueva M., Maestu F. et al. (2016) Specific features of subjective cognitive decline predict faster conversion to mild cognitive impairment. J. Alzheimers Dis., 52(1): 272–281.
  • Ilamakar K.R. (2014) Psychomotor retardation, attention deficit and executive dysfunctional in young non-hospitalised unmedicated non-psychotic unipolar depression patients. J. Clin. Diagn. Res., 8(2): 124–126.
  • Lee R.S., Hermens D.F., Porter M.A., Redoblado-Hodge M.A. (2012) A meta-analysis of cognitive deficits in first-episode Major Depressive Disorder. J. Affect. Disord., 140(2): 113–124.
  • Leiser S.C., Pehrson A.L., Robichaud P.J. et al. (2012) Preclinical studies of the multimodal antidepressant vortioxetine support a potential for improvement of cognitive functions. Eur. Neuropsychopharmacol., 38: 164–165.
  • Martin J.L., McLean G., Park J. et al. (2014) Impact of socioeconomic deprivation on rate and cause of death in 159 severe mental illness. BMC Psychiatr., 14: 261. DOI: 10.1186/s12888-014-0261-4.
  • McIntyre R.S., Cha D.S., Soczynska J.K. et al. (2013) Cognitive deficits and functional outcomes in major depressive disorder: determinants, substrates, and treatment interventions. Depress. Anxiety, 30(6): 515–527.
  • Meusel L.A., Hall G.B., Fougere P. et al. (2013) Neural correlates of cognitive remediation in patients with mood disorders. Psychiatry Res., 214(2): 142–152.
  • Milders M., Bell S., Platt J. et al. (2010) Stable expression recognition abnormalities in unipolar depression. Psychiatry Res., 179(1): 38–42.
  • Rock P.L., Roiser J.P., Riedel W.J., Blackwell A.D. (2014) Cognitive impairment in depression: a systematic review and metaanalysis. Med., 44(10): 2029–2040.
  • Roiser J.P., Sahakian B.J. (2013) Hot and cold cognition in depression. CNS Spectr., 18(3): 139–149.